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Diagnostic laparoscopy: indications and benefits

  • Current Concepts in Clinical Surgery
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Background

The increased availability of treatment options for gastrointestinal cancer, necessitates precise preoperative staging. Laparoscopy can be useful for establishing the diagnosis and staging of cancer. However, there is an ongoing discussion as to whether staging laparoscopy provides additional results despite newly developed imaging tools.

Methods

A systematic review of relevant literature was undertaken. The strength of evidence was classified according to the North of England Evidence Based Guidelines Development Project. Medline and manual searches were carried out to identify all published manuscripts of clinical trials that dealt with staging laparoscopy. Systematic quality review of those publications was used to verify staging accuracy, complications and trocar metastases.

Results

Only one randomized trial was performed in gynaecological cancer. In cervical cancer, as a result of this study, staging laparoscopy remains unproven. In gastrointestinal cancer (oesophageal, gastric, pancreatic, liver and colorectal cancers) only prospective and retrospective observational studies are available with an evidence-based level of grade B. As a result of these trials, staging laparoscopy, in a well-defined group of patients with locally advanced cancer, is recommended.

Conclusion

The effects of surgical staging in gynaecological cancer must be kept in mind but cannot be transferred to gastrointestinal cancer in general. Further studies are required to answer those questions.

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Authors and Affiliations

  1. Charité, Campus Berlin Buch, Klinik für Chirurgie und chirurgische Onkologie, Robert Rössle Klinik im Helios-Klinikum Berlin, Universitätsmedizin Berlin, 13122, Berlin, Germany

    Beate Rau & Michael Hünerbein

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  1. Beate Rau
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  2. Michael Hünerbein
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Correspondence to Beate Rau.

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Rau, B., Hünerbein, M. Diagnostic laparoscopy: indications and benefits. Langenbecks Arch Surg 390, 187–196 (2005). https://doi.org/10.1007/s00423-004-0483-x

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  • DOI: https://doi.org/10.1007/s00423-004-0483-x

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